How Is Growth Hormone Therapy Administered
Actual growth hormone therapy is only available with a doctors prescription and only delivered by a course of growth hormone injections.
HGH injections are administered daily. Patients will be taught to self-inject, and provided with kits, similar to those used by diabetics to take insulin shots. This is usually an easy and well tolerated process.
You will probably have to see your growth hormone doctor about every 6 weeks during the course of your HGH replacement therapy, so that he or she can monitor you condition and progress.
What Are The Longer
Treatment should start early and continue as long as the child is growing to prevent abnormally short stature and the consequent physical and problems this can cause. Treated children generally achieve relatively normal height and development as long as they are diagnosed early enough to give time for catch-up growth to occur. Like many medical conditions, this one requires regular specialist follow-up as an outpatient.
In the past, growth hormone treatment was stopped at the end of growth. It is now clear that growth hormone contributes to both bone mass and muscle mass reaching the best possible level, as well as reducing fat mass during adult life. The specialist is therefore likely to discuss the benefits of continuing growth hormone after growth has completed until age 25 to make sure bone and muscle mass reach the best possible level. In addition, growth hormone has been linked to a sensation of well-being, specifically energy levels. There is evidence that 3050% of adults with growth hormone deficiency feel tired to a level that impairs their well-being. These adults may benefit from lifelong treatment with growth hormone.
Last reviewed: Oct 2019
Growth Hormone Therapy Cost
Before a few years, the cost of growth hormone therapy was too much at about $1000 per month. This price has now come down to $500 per month and that too depending upon the dosage. This hormone is required in fewer doses in men than in women. Many insurance schemes cover the cost of growth hormone completely.
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Appendix: Summary Of Changes From The 2006 Guideline
Overall, the Guideline has been changed to reflect the structure of the newer guidelines, with each section started by the Recommendation or Suggestion, followed by the Evidence, and then sections on Remarks or Values. The more recent literature has been reviewed, new information and references have been provided, and some older information and references have been deleted.
A. The introduction has been greatly shortened.
B. Recommendation 1.3 regarding idiopathic GHD has been added.
1.3 Idiopathic GHD in adults is very rare, and stringent criteria are necessary to make this diagnosis. Because in the absence of suggestive clinical circumstances there is a significant false-positive error rate in the response to a single GH stimulation test, we suggest the use of two tests before making this diagnosis. The presence of a low IGF-I also increases the likelihood that this diagnosis is correct .
This specifically states that to make a diagnosis of idiopathic GHD in adults, decreased GH responses to two appropriate stimulation tests are needed. It was felt that elevation of the previous discussion about this to the level of a recommendation was needed to reemphasize that inappropriate use of GH in adults is not to be done.
C. Recommendation 2.1 regarding the ITT and GHRH-Arg testing was expanded.
D. Recommendation 2.2 regarding use of glucagon as a stimulation test has been added.
E. Recommendation 2.3 regarding the retesting of those with childhood GHD was expanded.
Benefits Of Growth Hormone Treatment
4.1. GH treatment improves body composition, exercise capacity, and bone mineral density in patients with GH deficiency.
GH deficiency can cause decreased bone mineral density, muscle strength, and exercise capacity, deterioration in memory, decreased physical activity and vitality, lethargy, difficulty in concentration, and sleep disorders . Patients also are exposed to a high risk of cardiovascular disease due to central obesity, dyslipidemia, or insulin resistance .
Several studies consistently reported that GH treatment had the significant effect on body composition including decrease in fat mass and increase in muscle mass . It was further reported that GH replacement led to a decrease preferentially in visceral fat and an increase in lean body mass , and improvements in muscle function and lipid metabolism can be expected as well. Studies in South Korea confirmed the tendency for GH treatment to achieve reductions in weight, body fat, and insulin resistance .
4.2. GH treatment lowers the risk of cardiovascular disease in patients with GH deficiency, but there is insufficient evidence regarding its effects on mortality reduction.
4.3. GH treatment improves quality of life in patients with GH deficiency.
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Growth Hormone Deficiency Disease
Growth hormone deficiency disease refers to the classic clinical presentations that accompany lack of or insufficient production of growth hormone. It is often associated with inadequate production of other pituitary hormones. In such a situation where other pituitary hormones are inadequately produced, the condition is referred to as combined pituitary hormone deficiency.
However, when growth hormone deficiency is not accompanied by any other hormonal deficiency, the condition is called, isolated growth hormone deficiency.
Isolated growth hormone deficiency
Just as the name suggests, isolated growth hormone deficiency is a condition where there is severe shortage or absence of growth hormone, though, without any other hormonal problem. Like other cases of growth hormone deficiency, people with isolated growth hormone deficiency have an unusually short stature due to failure to grow at the expected rate.
Complete absence of growth hormone is classified as Type 1A isolated growth hormone deficiency. In more ways than one, this is the most severe form of the deficiency disease out of all the four types. The classic presentation of this disease is very evident at birth because the affected babies are usually shorter than expected when they are born.
What is Partial growth hormone deficiency?
What is Idiopathic growth hormone deficiency?
What is Pediatric growth hormone deficiency?
Methods Used In The Development Of This Guideline
This guideline was developed by the Insurance Committee of the Korean Endocrine Society in consultation with the Korean Neuroendocrine Study Group, and the Korean Society of Pediatric Endocrinology. Since there are currently no diagnostic guidelines for GH deficiency and few domestic research has been conducted on this topic, the basis of this guideline was formed by consensus from panel discussion of experts, and the review of existing literature. When evidence was insufficient, recommendations were written according to expertsâ opinions. When there were differences in opinions, a majority vote was taken. Each recommendation was graded according to the strength of evidence supporting the recommendation, as defined in Table 2.
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Treatment Of Ghd Benefits Of Ghrt
There is a general consensus that many of the metabolic and psychological abnormalities associated with GHD can be reversed with GH replacement. Lower doses of GH may decrease the incidence of side effects from GHRT, while still achieving a clinical response to therapy . Treatment with GH results in profound changes in body composition, especially in reduced fat mass, and an increase in LBM. The decline in fat mass is most significant in visceral and trunk locations , suggesting that GHRT may reverse the central adiposity associated with GHD and potentially reduce the increased cardiovascular risk that this body composition carries . The increase in LBM is smaller than the reduction in fat mass, but appears to be more sustained .
An overall beneficial effect on serum lipid profile has been noted with GHRT in some studies, but data are inconsistent . When GHRT is added to lipid management therapy with HMG CoA reductase inhibitors , it may promote a synergistic effect . The reduction in atherosclerosis with use of GHRT has been assessed by several studies evaluating carotid IMT . In addition, GHRT has demonstrated improvement in pro-inflammatory and other cardiovascular risk markers, including C-reactive protein, apolipoprotein B, and homocysteine levels .
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Of Development Of Evidence
All GH in clinical use is biosynthetic human GH with a biopotency of 3 IU/mg, using the World Health Organization reference preparation 88/624 .
GH is currently approved by regulatory agencies for treatment of GHD in children and also for short stature due to causes other than GHD, such as Turner’s or Noonan’s syndrome, renal failure, short stature homeobox deficiency, small size for gestational age in patients who fail to catch-up to the normal growth percentiles, Prader-Willi syndrome, and idiopathic short stature. In the past, GH therapy has generally been discontinued once adult height has been achieved. Continuation of GH treatment in GH-deficient children after achievement of adult height will be discussed below.
GH treatment of GH-deficient adults has been approved since 1996, with the accumulation of much clinical experience. Although treatment appears to be safe overall, certain areas continue to require long-term surveillance, such as risks of glucose intolerance, pituitary/hypothalamic tumor recurrence, and cancer. Benefits of GH treatment of GH-deficient adults have been found in body composition, bone health, cardiovascular risk factors, and quality of life. However, reductions in cardiovascular events and mortality have yet to be demonstrated, and treatment costs remain high.
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Growth Hormone Deficiency Treatments
Replacing growth hormone to treat GHD involves:
Injection: You inject yourself every day with a small needle. Well help you become comfortable with this.
Side effects: When you first start the medication, you may have muscle or joint aches, and mild swelling from fluid retention. They usually improve after we adjust your dose to the right level for you.
Monitoring: We test your levels and adjust your dose as needed, to control side effects and improve your well-being. Well make sure you dont get too much GH, which can lead to muscle or joint pain, headaches and blurry vision.
Effects of treatment: The goal of GH replacement therapy is to improve your health and reverse GHD features, such as belly fat and low bone density. Many patients see significant benefits from GH replacement. They may gain improved bone density, greater ability to exercise and improved well-being.
Natural Treatments Of Growth Hormone Deficiency
If you are looking for a natural treatment of growth hormone deficiency, then we have it sorted for you.
There are many natural remedies that you can try to boost up your GH levels.
#1. Losing Body Fat
These supplements might help boost your HGH levels without any major side effects that are associated with replacement therapy.
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How Is Growth Hormone Deficiency Diagnosed
Diagnosis of growth hormone deficiency in children most often occurs during two age ranges. The first is around 5 years of age when children begin school. This is because parents can more easily see how their childs height compares to the height of their classmates. The second age range is around 10 to 13 years old in children assigned female at birth and 12 to 16 years in children assigned male at birth, which are the age ranges when puberty typically starts. A delay in puberty can signal suspicion of GHD.
Growth increments are the most important criteria in the diagnosis of GHD in children. Normal levels of growth usually follow a pattern, and if growth during a recorded six- to twelve-month period is within those ranges, its unlikely that they have a growth condition.
Adult-onset growth hormone deficiency is often difficult to detect because the symptoms are subtle and commonplace. This makes it more difficult to diagnose.
Symptoms Of Growth Hormone Deficiency
Children with GHD are shorter than their peers and have younger-looking, rounder faces. They may also have baby fat around the abdomen, even though their body proportions are average.
If GHD develops later in a childs life, such as from a brain injury or tumor, its main symptom is delayed puberty. In some instances, sexual development is halted.
Many teens with GHD experience low self-esteem due to developmental delays, such as short stature or a slow rate of maturing. For example, young women may not develop breasts and young mens voices may not change at the same rate as their peers.
Reduced bone strength is another symptom of AGHD. This may lead to more frequent fractures, especially in older adults.
People with low growth hormone levels may feel tired and lack stamina. They may experience sensitivity to hot or cold temperatures.
Those with GHD may experience certain psychological effects, including:
- bouts of anxiety or emotional distress
Adults with AGHD typically have high levels of fat in the blood and high cholesterol. This isnt due to poor diet, but rather to changes in the bodys metabolism caused by low levels of growth hormone. Adults with AGHD are at greater risk for diabetes and heart disease.
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What Is Growth Hormone Deficiency
Growth hormone deficiency is a rare condition in which your pituitary gland doesnt release enough growth hormone . GHD can affect infants, children and adults. Children with GHD are shorter than expected with normal body proportions.
Hormones are chemicals that coordinate different functions in your body by carrying messages through your blood to your organs, muscles and other tissues. These signals tell your body what to do and when to do it.
Your pituitary gland is a small, pea-sized endocrine gland located at the base of your brain below your hypothalamus. Its made of two lobes: the anterior lobe and posterior lobe. Your anterior lobe makes GH. It releases eight hormones in total.
People with growth hormone deficiency may have hypopituitarism and have a deficiency in other pituitary hormones, including:
- Antidiuretic hormone .
- Follicle-stimulating hormone.
- Adrenocorticotrophic hormone .
When Should I See My Healthcare Provider About Growth Hormone Deficiency
There are many reasons for slow growth and below-average height in children. At times, slow growth is normal and temporary, such as right before puberty starts. If youre concerned about your childs rate of growth, see a pediatric endocrinologist or healthcare provider. They can help find out if your childs rate of growth is cause for concern.
If youre an adult and are experiencing symptoms of growth hormone deficiency , talk to your healthcare provider.
If you or your child have been diagnosed with GHD, youll need to see your healthcare provider regularly to make sure your treatment is working properly.
A note from Cleveland Clinic
If youre noticing a lack of growth in your child, its important to talk to their healthcare provider as soon as possible. While it may be unlikely that growth hormone deficiency is the cause, any concerning changes are worth evaluating. People with GHD who are diagnosed early have the best outlook and usually lead healthy lives. If you have any questions about what to expect with your childs growth, dont be afraid to reach out to their provider. Theyre there to help.
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What Are The Signs And Symptoms Of Growth Hormone Deficiency
The signs and symptoms of growth hormone deficiency vary based on what age you are at the onset of the condition.
Symptoms of growth hormone deficiency in infants and children
Growth hormone deficiency in infants and children results in poor growth. The main sign of GHD in children is slow height growth each year after a child’s third birthday. This means they grow less than about 1.4 inches in height a year.
Other symptoms of GHD in children and infants include:
- A younger-looking face than whats expected for their age.
- Impaired hair and nail growth.
- Delayed tooth development.
- Low blood sugar levels in infants and toddlers.
Symptoms of adult-onset growth hormone deficiency
Symptoms of adult-onset GHD can be more difficult to detect. Symptoms include:
- Reduced sense of wellbeing.
- Insulin resistance, which can lead to Type 2 diabetes.
- Increase in LDL-cholesterol and triglyceride levels, which increases your risk of heart disease.
What Are The Signs And Symptoms Of Childhood
Signs and symptoms vary depending on the severity of the defect and the childs age and can be difficult to identify.
Babies born with growth hormone deficiency have a normal new-born size and generally show no signs at all, but can have low blood sugar levels or yellowish skin colour, which can be due to causes other than growth hormone deficiency.
In both early and later childhood, growth hormone deficiency is identified as slow growth compared with other children of the same age. . Often, the children look chubbier, shorter and younger for their age. Poor development of the bones in the middle of the face is also a sign of inadequate growth hormone. Body proportions and intelligence remain normal.
Growth hormone deficiency can be associated with deficiencies of one or several other pituitary hormones, for example those that control the thyroid or adrenal glands. Signs and symptoms may also be present because of these additional hormone deficiencies and there are many conditions that can cause poor growth and short stature that have nothing to do with growth hormone deficiency. This can make reaching the correct diagnosis a challenge.
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Is Hgh Therapy Safe
Prescription HGH injections are not like taking some falsely labeled HGH powder. HGH replacement injections are an actual medical procedure. As with any injectable pharmaceutical, HGH therapy has some risks and side effects. However, with proper monitoring and supervision of your treatment by doctors who are skilled and experienced in hormone replacement therapy , any side effects of HGH are minimized. Some of the most common side effects of growth hormone deficiency treatment have been fluid retention, and pain in the joints. But these, and any discomforts you may experience from growth hormone therapy, can usually be alleviated by adjusting your dosage.
The horror stories that are out there about HGH being dangerous, or even deadly, mostly derive from the illicit use, or abuse of HGH. If you get your growth hormone therapy from qualified and certified practitioners of HRT, growth hormone replacement therapy is generally safe and free of significant risks.
Remember, the goal of GHD treatment is to return your HGH level to what is normal for you and the needs of your body. With careful administration and monitoring, HGH replacement therapy is a safe and effective way to bring you back to your best version of you!